696 PAR T U 
own wife. This kind of accumulated evidence does in¬ 
deed remind us of Butler’s 
Sir Agrippa, for profound 
And folid lying much renown’d. 
Marvellous (lories at this time, however, met with a 
ready credence; and hence the operation began to ac¬ 
quire a certain degree of vogue, particularly on the-con¬ 
tinent, where it is faid to have been frequently performed 
with complete fuccefs. Laying out of our minds the ri¬ 
diculous exaggerations noticed above, it appears from an 
elaborate memoir by M. Baudelocque, tranflated into 
Englilh by Dr. Hull of Manchefler, that, during the 50 
years preceding 1802, the operation has been had recourfe 
to on the continent 95 times, and that 37 of thefe cafes 
proved fuccefsful. In Great Britain, on the contrary, 
this operation has been in almofi every inftance fatal to 
the mother. Records of twenty-two cafes are to be found, 
and twenty-one of the mothers perifhed. The folitary 
cafe of recovery is related by Mr. Barlow of Blackburn, 
in the Medical Records and Refearches (1798) ; but 
doubts have been entertained, whether in this cafe the 
incifion was actually made into the uterus. Of the chil¬ 
dren, ten were born dead ; and of the twelve extrafted 
alive, four furvived only a few days. The whole num¬ 
ber of lives preferved does not therefore exceed nine. See 
Merriman’s Synopfis of Difficult Parturition, p. 292. 
A very altonifliing cafe is dated to have oecured in Ire¬ 
land. The patient’s name was Alice O’Neal, and the 
operator was an illiterate midwife, one Mary Dunally ; 
the inftrument ufed was a razor, with which die firft cut 
through the containing parts of the abdomen, and then 
the uterus. “She held the lips of the wound together 
with her hand, till fome one went a mile and returned 
with filk and the common needles which tailors ufe. With 
thefe (lie joined the lips in the manner of the flitch em¬ 
ployed ordinarily for the hare-lip, and drefled the wound 
with whites of eggs.” The woman recovered in tvventy- 
feven days. However incredible this flory may appear, 
there feems no reafon to doubt its truth. It is related 
by Mr. Duncan Stewart, furgeon, in Dungannon, who 
law the patient fome days after the operation ; and the 
account is confirmed by Dr. Gabriel King, of Armagh, 
who fays, that he drew out the needles, which the mid¬ 
wife had left to keep the lips of the wound together. 
It has often been an objeft of inquiry, why this opera¬ 
tion fliould have been mere fuccefsful upon the conti¬ 
nent than in this country. Some writers have attribu¬ 
ted it to the climate of England ; but this cannot pofli- 
biy have had fufficient influence to prevent a recovery ; 
nor can it very well be attributed to the want of fkill in 
ourfurgeons, fmee they fucceed in other operations, ap¬ 
parently as hazardous. Perhaps the only fatisfaftory 
reafon that can be afligned for the remarkable difference 
in the refult of the operation performed in this country 
and on the continent is, that it has fcarcely ever been de¬ 
termined on in England until after long-continued fruit- 
lefs efforts have been made by the mother to expel the 
child, fo that her conftitutional powers, and the parts to 
be operated on, have been in the molt unfavourable pof- 
fible condition ; for it has been obferved, and with ap¬ 
parent reafon, that if it had been performed earlier, be¬ 
fore the ftrength of the woman had been exhaufled, and 
a feverifli indifpofition induced, or before the bladder 
and other foft parts had been injured by diilenfion and 
preffure, a more favourable termination might have been 
expected. Tt is at any rate certain, that all over the con¬ 
tinent praftitioners have lefs horror at performing the 
csefarean feftion than Britifli praftitioners have com¬ 
monly fliown ; and it is reforted to in cafes where the 
Operation of embryotomy is preferred in this country, 
and where of courfe the women are not in fuch a preca¬ 
rious date of health as thofe commonly are who have ex¬ 
treme narrownefs of the pelvis. This is evident from the 
accounts publilhed of women, who, after being fubjefted 
RITION. 
to the operation, have borne living children by the na¬ 
tural paffage, which could not happen if the pelvis were 
conliderably diftorted or mifhapen: and hence Dr. 
Haighton feems to think it probable, that the extraction 
of an extra-uterine foetus (as to which fee farther on) 
has repeatedly palled for an inftance of the cselarian flec¬ 
tion. But two modern French furgeons, Meffrs. Stein 
and Plenck, have laid down rules, calculated upon ac¬ 
curate, or fuppofed accurate, admeafurements of the pel¬ 
vis, as to when the veftis fliould be employed, when the 
forceps, when the perforator, when the feftion of the 
fymphylis pubis, and when the cselarean operation. See 
Merriman, p. 297. 
^ But the confideration of the propriety of performing 
this awful operation has not been left folely to the judg¬ 
ment of medical men. It has been made the fubjeft of 
ecclefiaftical difeuflion ; and the doftors of the Sorbonne, 
and the heads of theological fchools and colleges, have 
fneeiy given decilions. upon it. By thefe authoritative 
teachers, it has been ruled, that the caefarean operation 
ought to be performed, whenever it is known that the 
child is living, and it is impoflible by other means to ex¬ 
tract it alive , for they affert, that it is a deadly fin to per¬ 
forate the head of a living child in the womb. The 
clergy are inftrufted, in the event of the mother refufing 
to fubmit to the operation, to omit no means of perfua- 
ding her .- they are to point out all its advantages, and to 
intimate, that the operation is not fo painful as might be 
thought: they are direfted to fpeak of fubmiflion to it, 
as an aft of the greatefl love to God, and reugnation to 
his will, that can poflibly be fhovvn : it is even"fuggefted, 
that under fome circumftances, the patient might be 
forcibly confined, and the operation be performed 
againft her will. It is further declared, that phyficians 
or furgeons refufing to recomriiend or to perform the 
operation, when they fliould think it neceffary, would 
thereby render themfelves guilty of a deadly fin, and 
ought to be reprimanded by the magiftrates; and 
praife is given to an edift, in force in Sicily, which 
declares, that noperfon (hall be admitted to praftife as 
a furgeon till he has been carefully examined as to 
the manner of performing the exfarean feftion on the 
living mother. , 
Thefe canfes combined will explain the reafon, why 
this terrific operation is more readily acceded to on the 
continent than in this country; and we are happy to 
fay, that cafes requiring it are with us very rare ; that is, 
there are very few women whofe pelves are fo diltorted as 
not to allow a paffage for the fingers of (he accoucheur 
to conduft the neceffary inftruments for opening the head 
of the feet us fufficiently to allow its contents to be 
fqueezed out, and its bones to collapfe fo far as to allow 
the operator to fix a hook or crotchet, with which it may 
be gradually drawn down, and extrafted. Through how 
very narrow a fpace this may be done, we have a remark¬ 
able inllance related in Dr. Ofborne’s Treatife on Labo¬ 
rious Parturition. This gentleman has rendered himfelf 
particularly confpicuous on the fubjeft of the caefarean 
feftion, and ufes very ftrong language in reprobation of 
it. His arguments are—its acknowledged fatality; the 
capability of completing the delivery by means of the 
crotchet, in cafes of fuch deformity of the pelvis that 
there is no more than one inch and a half between the 
pubis and facrum, or to one fide of the projefting fa- 
crurn; and, the impoffibility of impregnation taking place 
in cafes of greater deficiency of fpace. 
Much controverly enfued upon Dr. Ofborne’s argu¬ 
ments; and fome of then: perhaps were (hewn to be un¬ 
tenable. But his reafoning has fo far prevailed, that Bri¬ 
tifli accoucheurs are always extremely reluftant to pro- 
pole tiiis operation ; and recourfe is never had to if, ex¬ 
cept in fuch deplorable cafes as preclude the poffibility of 
delivery by any other means. Such inftances have been 
met with ; and a fpecimen is now to be feen in the mufeum 
of Mr. Charles Bell, in which the diftortion of the pel¬ 
vis 
